Monthly Archives: August 2014

The University of Rochester School of Medicine and Dentistry 2014 Opening Convocation Ceremony will be held on Thursday, September 11th, 2014 at 4:00 pm in the Class of 62 Auditorium. A reception will follow the ceremony in the Flaum Atrium. Click here for the event flyer. Congratulations to CTSI program trainees, awardees, faculty members and alumni who will receive awards at this year’s ceremony:

“As a younger researcher, I want to be a team player, because the best science seems to come from strong collaborations,” said Abar. “But the best way to move up is to win those grants on your own — to be the P.I., to be the lead author. How can one do both?”

“That’s an issue that we talk about all the time,” acknowledged Kitzman.

As it turned out, the university was only weeks away from implementing updated tenure and promotion criteria specifically designed to reward talented team scientists for their contributions to collaborative research groups.

Jeffrey M. Lyness, M.D.

The new policies, which went into place on July 1, allow recognition for scientists who lead a defined portion of the work done by collaborative teams. Department chairs are encouraged to ask referee letter-writers to comment specifically about the unique role on the team played by such scientists. These materials are given serious weight in tenure and promotion considerations.

This allows talented team scientists to further their careers, even if they are not always in roles such as principal investigators for grants or lead authors for publications.

“Science has gotten too complicated and requires too many different types of expertise for one person. These days, groundbreaking science of almost every discipline happens in collaborative teams,” said Jeffrey Lyness, M.D., senior associate dean for academic affairs. “Tenure systems, however, were established to recognize the achievement of an individual, and in team science not everyone can be first author, senior author, P.I., or co-P.I.”

The new system, which was established following ample input from faculty across the Medical Center, received overwhelming support from department chairs before it was put into place.

Outside organizations have appreciated the changes, too: When Lyness exchanged emails about the new system with the staff of Ann Bonham, Ph.D., Chief Scientific Officer at the Association of American Medical Colleges, he received word that the university’s policies were on the “leading edge” in this area.

Karl Kieburtz, director of the CTSI

Since its inception, the CTSI has also played a lead role in supporting team science. Co-director Kitzman is currently working with several others within the Institute to learn more about what traits or characteristics make one team of researchers more successful than another. The Institute’s largest grant, the Incubator Program, is specifically designed to support research efforts that involve multiple investigators or departments.

“Translation of discoveries at the bench into care — maybe that hasn’t gone so well because people are pursuing individual awards,” said Karl Kieburtz, M.D., M.P.H., director of the CTSI. “So people may need to be educated about the benefits of team science and rewarded for that interdisciplinary approach.”

The various efforts are supportive of an environment that many faculty say sets the university apart from other academic institutions.

“Collaboration has always been key to the culture here. It’s part of what I loved about the school as a student, and part of why I came back as a faculty member,” said Lyness. “As Dean Taubman has noted publicly, our faculty turnover rate is low compared to our peer institutions, and I think that’s because of our culture.”

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If you’re a researcher with a question, Cindy Doane, M.P.H., M.S., probably has the answer.

Cindy Doane, M.P.H., M.S.

“E-record, vouchers and financial assistance, REDCap, access policies, needing to know when certain patients are admitted to the ER — it’s really any research-related question,” said Doane, administrator of the CTSI’s Research Navigator Program.

Doane has been helping to guide researchers to various resources both within the university since she joined the CTSI in March. Connecting with researchers either by email or in person, she assists with a wide variety of research-related requests.

In the instances where she doesn’t have an answer immediately, she reaches out to others in the CTSI, the University, or beyond to help provide support.

“If I can’t help them, I connect them,” she said.

For much of the past two decades, Doane has worked at the university, including a good deal of time as a study coordinator. She started in the Department of Pediatrics as an information analyst and worked her way up to senior project coordinator, also spending time in the Department of Psychiatry.

Her past experience in research made her an ideal fit for the position, as she is personally familiar with many of the challenges facing researchers and study coordinators.

“We were very excited to bring Cindy onto the team,” said Eric Rubinstein, J.D., M.P.H., executive director for research services at the CTSI. “With her wealth of research experience and familiarity with regulatory processes and University infrastructure, she is a tremendous resource to help teams get what they need to move their research forward.”

In addition to her work with the Research Navigator Program, Doane runs the ClinicalTrials.gov Consultation Clinics, which take place monthly in Saunders Research Building, and administers the Voucher System, where researchers can obtain small amounts of funding quickly and easily.

Doane also spent much of her first several months at the CTSI helping to develop the Research Request Dashboard, a one-stop web-based application that manages all the requests that come through the Research Navigator Program. The Dashboard, which will launch later in 2014, will allow users to log in and track the progress of their requests.

Two URMC trainees are beginning new research projects in 2014-2015 that are funded by the CTSI Pilot Studies Program. The CTSI pilot grant program is intended to provide seed funding to facilitate new research and future funding. Multidisciplinary research is strongly encouraged, as well as translational and clinical research that moves new discoveries along the translational continuum to humans and the community. Clinical and community based research, practice-based research, and health services research proposals are also encouraged. The CTSI Pilot Studies program is currently accepting applications for all of its funding mechanisms. Abstracts are due on September 2nd and the full RFA can be viewed here. This year’s trainee awardees are:

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Lesley Chapman and Molly Jaynes, who are students in the CTSI’s Translational Biomedical Science Ph.D. program, recently received F31 awards from the National Institutes of Health. These individual grants will fund travel and equipment purchases to further their research studies while providing them with living stipends for the duration of the award.

Read more about what Chapman and Jaynes are studying below.

A novel approach to malaria

Lesley Chapman

When it comes to fighting malaria, a deficiency can be an advantage.

That’s what Lesley Chapman discovered when studying mice who were missing a specific strand of microRNA.

“Mice that don’t have this particular microRNA have more immature red cells, so it’s definitely essential for life — you can become anemic without it,” said Chapman, a fourth-year student in the CTSI’s Translational Biomedical Science Ph.D. program. “But therapeutically, if you’re able to target this cell type, you can enhance the host response to malaria.”

The disease, which kills hundreds of thousands per year, is the leading cause of death in many developing countries. Chapman began studying it as an undergrad, when she researched the role of microRNA in red blood cells. As a graduate student, she wanted to take the idea one step further, and was able to show in cultures that if microRNA 451 was altered in platelets, then the cells were able to clear a malaria infection out more quickly.

The next step is to test the results at the next level, by taking the T-cells of mice without microRNA 451 and transplanting them into other mice to see if they have an improved response to malaria.

“This is very novel,” said Chapman. “I don’t think anyone has looked at microRNA in regulating T-cell response during infection.”

Should her hypothesis prove true, the therapy has tremendous potential for humans down the line. Chapman believes that by removing blood from a patient and targeting the proper cells, the modified blood could then be reintroduced into a patient’s body, giving them a much higher resistance to malaria.

Her award, which began on July 1 and spans the next year, will allow her to perform additional tests and travel to conferences that focus on the disease.

Helping musicians with dystonia

Molly Jaynes

Imagine playing an instrument and then, suddenly, feeling your fingers lurch off in a new direction.

“It’s really devastating, because as a musician, you self-identify with what you do, and then when you can’t do it any more, it alters your whole self-perception,” said Molly Jaynes, a third-year student in the CTSI’s Translational Biomedical Science Ph.D. program.

For several years, Jaynes has been studying focal hand dystonia, a neurological disorder characterized by involuntary hand motions that regularly ends the careers of musicians who develop it.

The rare disorder, as mysterious as it is devastating, has no cure, though Jaynes is working on new approaches to studying it. By having affected musicians execute a series of finger-tapping tasks — whereupon a number appears on a computer screen and the musician must press a button with the corresponding finger — Jaynes is hoping to establish a link between cognitive and automatic muscle control in people with the disorder.

“We want to see if musicians have a problem in that transition,” said Jaynes. “And if we find that they do, which we think they might, it could pave the way for interventional therapies and maybe cognitive rehabilitation strategies.”

Jaynes’s award, which spans the next two years, has already allowed her to travel to Stockholm, Sweden, for a conference on neurological disorders. She’s also hoping to bring her experiment on the road with her and visit musicians with focal hand dystonia in other cities — the rarity of the disease makes it impossible to get an adequate sample size if she only stays in Rochester.

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Every month, the CTSI Stories Blog will post excerpts from ongoing conversations with the institute’s co-directors.

Below, Nana Bennett gives an overview of the CTSI’s population health pillar, which was officially established in early 2014.

Nancy M. Bennett, M.D., co-director of the CTSI.

On the creation of the pillar:

The genesis of the Clinical and Translational Science Awards came from the idea that clinical and translational research – all research, really – should impact the health of the public more directly and rapidly than it currently does.

The problem in the United States is that our health outcomes are not as good as other countries despite spending much more. We also, obviously, have a robust research infrastructure, so you’d think we would be doing better. So Elias Zerhouni, who was the head of NIH when the CTSA program started, was interested in that gap and tried to create a vision of how research could improve health more rapidly.

So when we started the Rochester CTSI, we wanted our research enterprise to contribute more directly to public health. One of the required elements of the CTSA program was community engagement — to provide support to investigators in working with the community. We conceived of community engagement as a tool to improve the translation of research into the community and also to serve as a bridge to the community, so their concerns could be brought into the academic institution. So when we created our community engagement core, we worked with the community very closely and built a lot of infrastructure for that dialogue to continue. This all happened at the same time we were starting the Center for Community Health (CCH), so it was perfect timing, because it all dovetailed with the mission of the CCH.

But over time, nationally, it seemed as though community engagement became the goal rather than the way to get to the goal. When Karl Kieburtz took over the CTSI and we started to think about our strengths and the ways we could make a contribution, it appeared that population health was an area that was important on all fronts. It was important to the public health of this community. It was important to the institution. It was important to the design and focus of emerging care structures in health care reform. And it was important to the research side because we need to translate what we know immediately into health improvement, and that’s population health.

A critical part of population health is informatics. We can only think about the health of populations if we have the data. So a central part of the transformation of the CTSI is the growing strength of our informatics capacity.

On how big data ties in to population health:

A lot of our big data efforts are focused on how we bring disparate data sets together to define the multiple determinants of the health of populations and how we approach patients as part of a population. The latter concept is nothing new — Peter Szilagyi was one of the earliest people to talk about viewing one’s patients as a population, and his immunization work is an excellent example of viewing a pediatrics practice as a population group in assessing immunization rates. But now we’re focusing on how to think about the data itself in a different and broader way.

With Tim Dye coming back to the institution, we’re taking a new look at how we’re going to use biomedical informatics with population health as a focus. A population might be the patients that come to a particular clinic, or it might be all of the people who come to URMC, or it might be the population of Monroe County, or the population of all 13 counties that we serve.

Currently, we mostly use public health data to look at larger populations — we don’t use clinical data very much because of access limitations and technical issues. Now we are preparing to be able to use clinical data to more completely define the health of a population – combining it with more traditional public health data – survey data, reportable conditions, etc – trying to think of ways that we can collaborate with the other health care systems in the area over data, and not have data be a competitive entity. That’s one of our big challenges right now: thinking about systems that enable us to share data in ways that don’t interfere with the institution’s proprietary interest. Because the future of health care is looking at population data, understanding what works, and applying those lessons directly to what we do clinically.

On what to expect in the future from the CTSI in terms of population health:

Our focus will be on improving the health of the Rochester region and helping to drive the direction of our clinical enterprise to improve the overall health of our patient population. In some ways, we are farther along with respect to driving public health than we are in the clinical realm, because we have developed such robust partnerships throughout the community. Then, as mentioned, we want to integrate those two things: We want to think about the community as a whole and focus on what is most important to the community, but use clinical data and comparative effectiveness research to determine our directions.

In the nearer term, we have four specific objectives: 1) Develop methods to measure and demonstrate improvements in population health; 2) Increase capacity to make use of population health data; 3) Increase the institutional capacity to conduct community-engaged population health research; and 4) Increase early-career training opportunities in population health and population research. The CTSI lecture series in Spring 2015 is going to focus on population health. Bob Holloway, the leader of the series, is working with us to plan it and we will share details as soon as they are available. We hope that the series will be a great kick-off for our ongoing efforts.

Previous director’s updates:

July 2014 – Harriet Kitzman offers her takeaways from the Mini Summer Research Institute.June 2014 – Karl Kieburtz gives an overview of the CTSI’s six pillars.